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Collagen Fleece Helpful for Certain Penile Surgeries

Collagen Fleece Helpful for Certain Penile SurgeriesCollagen fleece, when used as a graft material during penile surgery, might reduce the likelihood of residual curvature in men with both Peyronie’s disease and erectile dysfunction (ED).

Peyronie’s disease occurs when the penis is injured and doesn’t heal properly. Areas of hardened scar tissue called plaques form just beneath the skin’s surface, which makes the penis bend when it’s erect. Some men have pain, and intercourse can become difficult.

One surgical treatment for Peyronie’s disease is plaque incision and grafting. During this procedure, a surgeon makes an incision in the plaque itself and fills the area with a grafting material to straighten the penis.

However, some men with Peyronie’s disease also develop ED. These patients may decide to have a penile implant procedure. This surgery involves removing the corpora cavernosa – the spongy tissue that fills with blood during an erection – with a penile prosthesis. Usually, the device is an inflatable version that the man can control through a pump implanted into his scrotum. This allows a man to start and end an erection as he chooses.

For about 60% of men, the surgery also takes care of the curve from Peyronie’s. Unfortunately, however, this isn’t the case for all men, especially if the bend in their penis is substantial to begin with. There might still be some residual curvature even with the implants.

A recent Journal of Sexual Medicine study suggests an additional approach. Surgeons report that using collagen fleece as a grafting material could resolve the residual curve. One benefit of this material is that it does not need to be sewn into place. Instead, it has self-adhesive properties.

Fifty-one men (average age 60 years) with both Peyronie’s disease and ED participated in this retrospective study. Their average Peyronie’s curvature was almost 70 degrees. All participants underwent penile implant surgery along with plaque incision and grafting using collagen fleece material. Afterward, their progress was monitored for an average of 11 months.

At their last follow-up appointment, all of the patients said they had satisfactory erections. About 12% of the patients still had a residual curvature of under 15 degrees; this result was more likely in patients whose curve before surgery was 60 degrees or more. Three patients did need subsequent surgery to address problems that did not appear to be related to the graft.

Satisfaction rates were high. Ninety-six percent of the patients said they were “satisfied” or “very satisfied” with their results. And 94% said they would have the procedure again.

The authors acknowledged that the follow-up period was less than one year, so it’s unclear what long-term results would be. The lack of a comparison group was another noted limitation.

Resources

 The Journal of Sexual Medicine

Hatzichristodoulou, Georgios, MD, FEBU, FECSM, et al.

“Multicenter Experience Using Collagen Fleece for Plaque Incision With Grafting to Correct Residual Curvature at the Time of Inflatable Penile Prosthesis Placement in Patients With Peyronie's Disease”

(Full-text. Published: March 18, 2020)

https://www.jsm.jsexmed.org/article/S1743-6095(20)30123-5/fulltext